When is escharotomy most commonly performed?

Escharotomy is most commonly performed for circumferential burns. Circumferential burns encircle a limb or the torso, creating a rigid eschar that can restrict blood flow and compromise respiratory function due to pressure buildup. This rigidity occurs because the burned tissue dries and contracts, acting like a tourniquet.

Performing an escharotomy involves making incisions through the eschar to relieve pressure. This surgical intervention helps restore circulation, reduces the risk of further tissue ischemia, and can be critical in preventing complications such as compartment syndrome.

In contrast to circumferential burns, deep second-degree burns may not require an escharotomy unless they also present with significant swelling and pressure. After skin grafting procedures, escharotomy is generally not indicated, as these procedures focus on wound closure rather than addressing issues of circulation. Lastly, while initial assessment is crucial in burn management, escharotomy is not typically performed at this stage; it is a surgical intervention that follows the initial evaluation of the patient’s condition.